POS0610 THE RELATIONSHIP BETWEEN SYSTEMIC MANIFESTATIONS OF RHEUMATOID ARTHRITIS AND THE STRUCTURAL GEOMETRY OF THE MYOCARDIUM.
Authors: L. Feiskhanova, D. Abdulganieva
Journal: Annals of the Rheumatic Diseases (2022)

Background In recent years, chronic inflammatory diseases, including rheumatoid arthritis (RA), have been perceived as independent risk factors for cardiovascular diseases. In addition to influencing the development of atherosclerosis, rheumatic diseases are accompanied by changes in the myocardium. Objectives to determine the relationship between systemic manifestations of RA and structural changes of the heart. Methods The 282 patients (240 women and 42 men) with verified RA were examined. In addition to standard diagnostic tests, all patients underwent echocardiography with tissue Dopplerography of the myocardium. Results Structural and geometric remodeling of the heart was detected in 146 patients (51.8%), of which 29 had concentric remodeling, 35 had concentric hypertrophy, and most often, 82 people had eccentric hypertrophy. The average age was 57.9±8.55 years in the group with cardiac remodeling and 47.2±11.92 years in individuals with normal heart geometry, respectively (p&lt;0.0001). Among 136 patients (48.2%) with normal heart geometry, 39 people suffered from arterial hypertension, 79 patients had various systemic manifestations of rheumatoid arthritis (Sjogren’s syndrome, rheumatoid nodules and/or cryoglobulinemia). Among those with cardiac remodeling, arterial hypertension was diagnosed more often – in 107 people (p&lt;0.0001), and systemic manifestations of rheumatoid arthritis - in 87 patients (p&lt;0.1). A comparison was made between a group with eccentric hypertrophy (82 people) and a combined group of patients with concentric remodeling and concentric hypertrophy (64 people). In the first group, the age was higher and amounted to 58.6±8.52 years, and in the second – 57.2±7.96 years (p&lt;0.05). In the first group, systemic extra-articular manifestations of rheumatoid arthritis were found in 56 individuals (68.3%), and in the second group – in 33 people (51.6%) (p=0.04). It is worth noting that in the second group, patients with concentric hypertrophy made the greatest contribution: out of 35 people, systemic manifestations of rheumatoid arthritis were detected in 23 people (65.7%), which is comparable to the frequency among people with eccentric hypertrophy. In this regard, for the research purpose, we combined individuals with normal geometry and concentric remodeling into one group (165 people), and patients with concentric and eccentric hypertrophy into another group (117 people). When compared, it was found that regardless of the type of myocardial hypertrophy these individuals are significantly more likely to suffer from systemic manifestations of rheumatoid arthritis: 53,9% and 67.5%, respectively (p=0.02). Conclusion the formation of myocardial hypertrophy in patients with rheumatoid arthritis is associated with more frequent development of extra-articular manifestations of this disease. References [1]Patel KHK, Jones TN, Sattler S et al. Proarrhythmic electrophysiological and structural remodeling in rheumatoid arthritis. American Journal of Physiology - Heart and Circulatory Physiology. American Physiological Society, 2020. Nov 1;319(5):H1008-H1020. doi: 10.1152/ajpheart.00401.2020. [2]Sherif F. Nagueh, Otto A. Smiseth, Christopher P. Appleton et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart Journal - Cardiovascular Imaging, Volume 17, Issue 12, December 2016, Pages 1321-1360. doi.org/10.1093/ehjci/jew082. Disclosure of Interests None declared